PLAN COULD FORCE DOCTORS TO SIGN CONTRACTS.

Byline: Michael Coit Staff Writer

Physicians could be locked out of hospitals unless they sign contracts, under legislation a state Assembly committee is expected to take up today.

The measure would extend existing state law so that all medical specialties can be covered by contracts if hospitals demonstrated they would improve patient care or assure medical services would be available.

Physicians who oppose the legislation contend patients would have fewer choices over their care because hospitals would control referrals rather than physicians practicing in open settings.

But supporters of the legislation said it would ensure that hospitals can provide treatment from specialists. They said hospitals need to be able to provide specialized services on demand, and physicians are not always available.

``Hospitals need this in order to assure the services,'' said Donna Kaylor, the lobbyist representing the California Healthcare Association on this issue. ``Sometimes the only way a hospital can get specialists to come in is through contracts.''

Physicians, however, said the law would be detrimental. They said contracting would reduce competition to manage costs at the expense of a patient's ability to choose treatment.

``We are not a hospital's employee. I am accountable to my patients. With this contract, they are trying to turn it around,'' said Dr. Pejman Salimpour, an Encino physician leading the fight against the measure. ``They want that control to fire doctors and kick them out and bring in their friends.''

Salimpour began his fight two years ago when he and other physicians in his group were not allowed to treat babies at the neonatal unit at Providence Saint Joseph Medical Center in Burbank.

Providence changed its policy of exclusivity after Salimpour's complaints prompted an investigation by the state Department of Health Services. The medical center recently sent a nonexclusive contract for neonatal privileges to Salimpour.

California allows hospitals to use exclusive contracts to provide pathology, radiology and anesthesiology services. But some hospitals have exclusive contracts covering other areas, such as neonatal care and nephrology.

The proposed measure would require those and future contracts to be nonexclusive and provides regulations.

Hospitals would have to demonstrate a nonexclusive contract was needed to improve care or assure adequate physician coverage for various medical services. Patients could not be denied services of their physician if the physician has medical privileges with the hospital.

Among the California Medical Association's concerns with the legislation are:

--Professional duties could be dictated by hospital administrators rather than medical staff rules.

--Doctors would have to be in a medical group large enough to guarantee coverage at any time.

--Charity care could be disrupted.

--Doctors could be subject to termination without cause.